Pellagra is a disease caused by deficient niacin (vitamin B3) and/or the amino acid tryptophan in the human diet. Symptoms of the disease range from mild to severe and include skin lesions, diarrhea, weakness, muscle confusion, and even dementia. If untreated, pellagra may kill its sufferer within four to five years.

Pellagra is most common in populations who obtain much of their food energy from maize. Outbreaks most commonly occurred, then, where maize was the “staple crop” of a civilization. Corn was for many years misunderstood as a carrier of disease or a certain toxic substance. Misunderstanding, apparently, was the name of the game: The corn itself was not a carrier of any disease (for, it must be noted, indigenous populations who were the original cultivators of corn, did not suffer). The traditional method used by Native Americans to prepare the corn for consumption required the treatment of the cobs with lime, an alkali. This process is referred to as “nixtamalization,” which allows the corn to release its niacin and tryptophan in the body. The usefulness of this treatment method was not understood, and was therefore overlooked by New World settlers, often with dire consequences.

In the 1900s, pellagra reached epidemic proportions in the American South. At that time, the diet of the Southerners consisted in large part of two components: pork and corn (fatback pork, interestingly, tends to further exacerbate a niacin deficiency). In 1916 alone, over 100,000 cases of pellagra were reported in the Southern states, sparking a frenzied response in the U.S. government as well as the medical community. Much effort went into the research and understanding of the causes and epidemiology of pellagra and the specific role of its pervasive, iconic culprit.